Run for Your Life

by Mark Cucuzzella

  Kale and walnut pesto. This is a low-budget alternative to regular pesto. Mix together ½ cup of hard Italian cheese (Parmesan, pecorino Romano), ¼–½ cup of walnuts, ½ cup of olive oil, 2 cups of loosely packed kale, a clove of garlic, and salt. Mix in a food processor. Use this to top anything.

  Micro bacon. Use farmers’ market bacon, if possible. In a microwave bacon pan, microwave for about a minute per slice, if thickly cut. Perfect every time, and no mess.

  CHAPTER 11

  Recovery Is the Training

  Once reduced to “the plod” it’s only a matter of time before injury, illness, or poor performance occurs. We’ve come to understand this is a protective response of an exhausted body.

  —BRUCE FORDYCE, nine-time Comrades Marathon champion

  MYTH: If we want to become stronger and healthier, we must exert at the highest capacity we can tolerate.

  FACT: Technically, it’s only during recovery that we become stronger and healthier. Adequate sleep, nutritious food, and relaxed, comfortable movement are the most important contributors to this process.

  Racing is optional. But rest and recovery after any vigorous activity is mandatory. Recovery is the time when your body repairs and strengthens, which doesn’t happen while you are exerting. Recovery should not become a routine of rehabilitation and physical therapy.

  The body has marvelous built-in mechanisms for adaptation, repair, and remodeling. When stresses are applied to the bones, tendons, and muscles, the body grows stronger as the repair work does its magic. But this presupposes the right amount of stress (also known as eustress), and also adequate time for the rebuilding process to occur.

  The inflammation (and free radical production) in our muscles that follows mild stress is transitory and good—or mostly so. When tenderness or pain accompany inflammation, it is a signal to rest and protect ourselves. If instead we persist with high levels of physical and emotional stress, and a poor diet, we are setting ourselves up for chronic oxidative stress and inflammation. Chronic inflammation (literally meaning slow burning fire) is mostly invisible, can occur in any tissue or organ, and makes us vulnerable to disease and deterioration.

  JUST SAY NO TO NSAIDS

  Contrary to popular belief, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen don’t help with recovery, because they short-circuit the mild inflammation that is an integral part of the repair and rebuilding process. Cortisone injections are worse: injections into or around an injured tissue may offer some pain relief, but they interrupt the repair and remodeling process.

  The body will always try to heal. Chronic usage of NSAIDs impacts the repair process and prevents the body from healing back to baseline tissue strength.

  This weaker, impaired tissue is now at a greater risk for reinjury.

  THE HEART OF TRAINING

  Many elite endurance athletes experience orthopedic overuse injuries such as plantar fasciitis, Achilles tendonitis, shin splints, and chondromalacia patella. But researchers are increasingly finding that overtraining and too much endurance racing may be more damaging to another key organ—the heart—than previously suspected. Sports cardiologists caution that cardiac overuse may be associated with right heart cardiac strain and failure, cardiac arrhythmia, accelerated coronary plaque formation, premature aging of the heart, myocardial fibrosis, plaque rupture, acute coronary thrombosis, and even sudden cardiac death.

  One friend of mine, Boston Marathon director Dave McGillivray, exercised regularly until he had a wake-up call at age fifty-nine. Six months after the 2013 marathon—the year of the bombings—he was diagnosed with coronary heart disease. (The bombings had no doubt added to his overall stress.)

  Following his diagnosis, he took what he had learned to heart, so to speak. He slowed down, cleaned up his diet, and lost thirty pounds. The day before the 2014 race he addressed the Sports Medicine Symposium of the American Medical Athletic Association (AMAA) as the picture of health, in body and spirit. He began by thanking the first responders who had treated the bomb victims the year before, then spoke about several of his physically fit running friends who had gone out for runs and hadn’t made it home—felled not by improvised bombs but by heart attacks. “I spent a lifetime trying to be fit,” he said, “but I didn’t spend time trying to be healthy.”

  In the company of friends, Dave completed the race in the evening hours. Six months later, he qualified for and entered the grueling Ironman World Championship in Kona, Hawaii—the pinnacle of Ironman races. It was his first Ironman in twenty-five years, and he finished in a respectable 13 hours.

  In addition to contributing to coronary inflammation, over-exercising (without sufficient recovery time) can leave scar tissue on the heart in the form of patchy cardiac fibrosis. This may afflict as many as 10 percent of today’s serious marathon runners. The thick-walled left side of the heart can handle the stress, but the thin-walled right side seems better adapted to easy walking and jogging, not to daily hour-long high-tempo runs at the anaerobic threshold.

  I’ve run many miles over the past thirty-five years, most of them at a comfortable pace. I feel fortunate that my echocardiogram and other markers of cardiac health check out normal.

  HEART RATE VARIABILITY IS A GOOD THING

  Recovery is often thought of in terms of tissue-specific work, such as foam rolling, gentle stretching, icing, contrast baths, or massage. But biological and hormonal recovery is just as important. The key indicators of this recovery are a lowered resting heart rate, healthy appetite, and improved mood and sleep patterns—along with a compelling desire to get out there and run again.

  One emerging tool for assessing recovery and well-being is called heart rate variability, or HRV—a measure of the variation in the intervals between heartbeats. If your heart beats like a metronome, with intervals of identical length between each pulse, you have low HRV. A low HRV reading actually indicates poor recovery response and high sympathetic tone (or stress). If your heartbeat intervals vary, you have high HRV, which indicates more parasympathetic (“rest and digest”) tone, better progression and responsiveness during recovery, and more stress reduction. Note that too much stress (and overtraining) tends to negatively affect your HRV, while quality sleep benefits it.

  Until recently, measuring HRV required expensive monitoring devices found only in cardiac labs. But a good-quality Bluetooth heart rate monitor, paired with an inexpensive app such as Sweet Beat or Nature Beat, can now readily measure HRV. I use an app to measure my HRV several times a week, upon awakening, and the results seem to correspond well with my workload, sleep quality, level of recovery, and overall stress level. A low HRV reading (with more of a metronome-like beat) indicates that I should dampen the pace of my daily run to “slow jogging” level. That’s not a problem. As counterintuitive as it may seem, I look forward to slow jogging as much as to running at a higher pace. (My dog likes the slower pace, too, for the added sniffing opportunities.) Recovery is what it’s all about, and even after a ridiculously slow run I always feel better.

  DREAM THROUGH YOUR RECOVERY

  One of the most important recovery drills couldn’t be more straightforward: sleep. The benefits of sleep to mental function, neurocognition, and hormonal restoration are well known, even if the mechanisms by which they restore us are not entirely understood. We could reasonably refer to it as “sleep doping,” for its remarkably beneficial effects. If sleep was not necessary, it would be evolution’s greatest mistake.

  Sleep doesn’t come easily for many of us. Three-quarters of Americans are walking around with a sleep deficit. In the absence of sound, restorative sleep, our appetite increases, insulin resistance increases, growth hormone is suppressed, tissue repair is inhibited, and mood is altered.

  How do you feel? Tired? Uninspired? In a sour mood? If so, going to bed earlier and maintaining good sleep habits may be the single mos
t important health advice I can offer.

  Sleep is divided into REM (rapid eye movement) sleep and NREM (the nonrapid kind). NREM is further divided into stages N1, N2, and N3. Slow wave sleep, N3, is the deepest and longest. REM comprises 20 percent of a night’s sleep, and is when most of our dreaming and rebuilding occurs, and when the powerful recovery hormones testosterone and estrogen are released.

  We progress consecutively through all four stages in approximately ninety-minute cycles. Most of us need five to six full sleep cycles each night. If you have a sleep shortfall for a day or so, you can make up for much of it with a soundly restful night or two (during the weekend, for instance). Even a nap can pick up a lost cycle.

  A hormone called melatonin promotes sleep. But at night, artificial light has the opposite effect, by throwing the circadian rhythm—the body’s biological clock—out of whack. Blue light wavelengths inhibit the release of melatonin more than other colors, and are especially disruptive of sleep.

  It’s best to not view digital screens, including smartphones, for at least an hour before bedtime. If you have to use a screen at night, you might try a free app called f.lux, for your computer, or Night Shift for your smartphone. They automatically transition your screen to a more amber light spectrum after sunset.

  Another powerful regulator of sleep-wake cycles is the morning sun. A few extra minutes in the morning to run, walk the dog, or simply walk to (or park farther from) the office can do wonders for your daily wakefulness and the quality of your sleep.

  Growth hormone (GH) is another hormonal recovery friend, and is secreted during the N3, slow wave sleep phase. (Waking a child from this stage is nearly impossible.) The duration of the N3 cycle decreases with age, partly explaining why we recover differently at age fifty than at twenty-five. Fragmented and foreshortened sleep causes the levels of blood sugar and cortisol to rise, curtailing the restorative functions and healthy healing of the body. Sleep apnea commonly travels with obesity and metabolic syndrome, and circumvents the important N3 sleep phase. This contributes to a vicious cycle of more physiologic stress and less recovery, resulting in a greater incidence of high blood pressure, heart disease, diabetes—and auto accidents.

  EATING AFTER EXERCISE

  During exercise, insulin-independent pathways for glucose utilization and disposal are activated in the muscles. In other words, the muscles and liver are more carbohydrate tolerant during exercise, and for up to an hour after a workout. This means that even if you are insulin resistant, there is a small window for a bit of what is called “carb backloading,” and you may be able to consume some quality carbohydrates. You must earn your carbs!

  The fastest way to recover from more intense workouts and races is to eat a healthy meal within the next hour. Recommended post-activity nutrition depends on your metabolism, muscle mass, genes, and goals. If you simply want to run for general health and fitness, without a specific goal of fat loss or diabetes reversal, then include some healthy whole food carbs with your fat and protein. The carbohydrates will elevate your blood sugar slightly, signaling the pancreas to release insulin. This drives the amino acids (protein building blocks) and essential fatty acids from the food and into the muscle cells, hastening healing and growth. The healthy low-carb food is your foundation, and the modest amount of carbs (only after exertion) act as a supplemental fuel refill for the tissues. Following a hot summer run, a side of fresh melon with some salt does wonders for me. Individual results will vary, so experiment!

  Your goal should be to use fat as your primary fuel throughout the day. Have an omelet with some veggies, or a bunless burger in a leafy wrap. Athletes trying to reverse type 2 diabetes or obesity may want to learn about and test-run a ketogenic diet, which consists of quality, natural fats, adequate protein, and very few carbs. One eats to satiety, not in excess. This diet enlists ketone bodies—a breakdown product of fat metabolism—as a source of fuel for the brain and muscles. Full discussion of the science of a well formulated ketogenic diet is beyond the scope of this book. (See The Art and Science of Low Carbohydrate Performance, by Drs. Jeff Volek and Stephen Phinney.)

  As part of your recovery, don’t forget hydration. Follow your thirst. If you don’t fully trust that, check your urine: the color of light beer is good. Darker than that (e.g., Guinness)—not so good. Add a squirt of lemon or lime to your water, for flavor. And before a summer run, drink some water with a small amount of dissolved sodium to help super-hydrate your cells. You’ll be internally stashing an extra water bottle, in effect. For active, healthy people who are not salt sensitive, 3 to 5 grams of total sodium per day is the optimal healthy range—despite conventional wisdom suggesting salt’s danger.

  SLOW JOGGING AS A CURE FOR RUNNING

  Another method of “active recovery” is slow jogging, especially good when the fascia is sticky and mildly inflamed and the muscles are restricted and sore.

  I was honored to have Dr. Hiroaki Tanaka, a professor at Fukuoka University (see his book Slow Jogging: Lose Weight, Stay Healthy, and Have Fun with Science-Based Natural Running) participate in two of my Healthy Running courses. He calls his method of easy, relaxed jogging “niko niko running,” or running with a smile, and it has become popular in Japan.

  How to do it? Think about mastering the art of landing softly. Then begin slowly. Really slowly. Gently hop up and down a few times as if jumping rope, and land with softness and spring. Jog in place, then move a bit forward and backward. Breathe slowly and fill the belly. As best you can, move your body through its full range of motion.

  One appealing feature of slow jogging is that you can do it anywhere—in the mall, at airports, and in the workplace. Running hard and fast comes later. Dr. Tanaka’s program led him to a 2:38 marathon at age fifty.

  AVOID THE BLACK HOLE OF TRAINING

  Recovery is about taking time to manage your training and exertion level. If you try to maintain a fast pace every time you exercise—too fast to tap into your storage tanks of fat, yet not exactly sprinting or exerting anaerobically—you’re training in what Dr. Stephen Seiler calls the “black hole of training.” In the hybrid car analogy, you can detect this black hole when you believe you are cruising along efficiently, but then see that the MPG meter reads 15, instead of your estimated 99. You are in gas-guzzling (sugar) mode, which is not sustainable for long periods. You won’t boost aerobic development.

  Most athletes, from beginners to elites, spend too much of their training time in this gas-guzzling, high-end aerobic zone, and it ends up inhibiting their performance, with toxic effects. It’s not a coincidence that marathoner Ryan Hall trained like a beast—above a level that his body could sustain—and then retired at thirty-three. Many athletes plateau at a level well below what they might have reached had they trained aerobically, at a slower pace.

  That’s where the adaptation curve comes in.

  A plateau can be described as level high ground. Many of us never reach it. If too little recovery time is allowed, the body doesn’t fully recover. That’s overtraining. Repeatedly, I see proponents of the “no pain, no gain” approach who simply aren’t able to maintain a high level of performance. As Arthur Lydiard said, “Train, don’t strain.” He understood and respected hormesis, or eustress: carefully dosed levels of stress, combined with rest, result in growth and success.

  Now, at age fifty-one, I realize that my days of improving performance are likely over. In order not to lose ground, I look for the sweet spot of training: the point at which the load applied doesn’t exceed my body’s capacity to adapt. Frank Shorter said that the harder he trained with speed, the more he needed to recover with the gentle slow stuff.

  In our busy lives, recovery may be difficult, but it’s nonnegotiable.

  THE ADAPTATION CURVE

  When you subject your body to a training workout, your fitness level temporarily decreases

  During the subseque
nt recovery period your fitness level will rebound beyond the previous fitness level

  This is called super-Compensation

  There’s an old coaches’ principle: training success = moderate stress + adequate rest. With any moderate or strenuous activity, fatigue eventually occurs and performance declines. That’s followed by an adaptation/recovery phase in which super-compensation occurs, establishing a slightly higher platform of performance for the next period of exertion.

  DAILY RECOVERY VERSUS RACE RECOVERY

  When planning your race or your workout session, think ahead to the all-important recovery phase and set an internal detector: if you feel you are having an exceptional, “breakthrough” race or training run, it can be a red flag. With unusual speed and strength comes a mild state of euphoria and a peak in adrenaline—which most of us read as a sign to push harder. Often as not, however, this is a warning sign that you are overtraining and at risk of throwing your recovery cycle out of synch, extending the time needed for recovery. You can’t hurry a hen in her laying of eggs: you can only lay so many, and in certain seasons.

  Seek a high plateau, not a peak. Find the pace at which you’ll lay the maximum number of quality eggs over an extended period of time. Simply stated, any recovery activity—whether a walk, jog, massage, swim, or meditation—should make us feel better after the activity than we did before. We don’t need to add stress to an already busy life.